THE COMMUNITY COUNSELING & HOUSING SERVICES (NPI# 1477052058) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477052058 |
| Entity Type | Organization |
| Organization Name | THE COMMUNITY COUNSELING & HOUSING SERVICES |
| Other Organization Name | THE PETROVA HOUSE |
| Practice Address |
2407 Petrova Ave Jennings MO 63136-3903 |
| Mailing Address |
4166 Lindell Blvd Apt 1b Saint Louis MO 63108-2923 |
| Practice Telephone | 3145803029 |
| Mailing Telephone | 3145803029 |
| Enumeration Date | 2018-02-08 |
| Last Update Date | 2018-02-08 |
| Authorized Official Name | DR. MARVIN SHELTON (CEO) |
| Authorized Official Telephone | 3145803029 |
| Authorized Official Credential | ED.S, ED.D, RADC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101YA0400X |
Counselor Specialization: Addiction (Substance Use Disorder) |
Behavioral Health & Social Service Providers | ||
| N | 251B00000X | Case Management | Agencies | ||
| N | 253Z00000X | In Home Supportive Care | Agencies | ||
| N | 261QV0200X |
Clinic/Center Specialization: VA |
Ambulatory Health Care Facilities | ||
| N | 3104A0630X |
Assisted Living Facility Specialization: Assisted Living, Behavioral Disturbances |
Nursing & Custodial Care Facilities | ||
| N | 323P00000X | Psychiatric Residential Treatment Facility | Residential Treatment Facilities | ||
| N | 324500000X | Substance Abuse Rehabilitation Facility | Residential Treatment Facilities | ||
| N | 3336M0003X |
Pharmacy Specialization: Managed Care Organization Pharmacy |
Suppliers | ||
| Y | 3104A0625X |
Assisted Living Facility Specialization: Assisted Living, Mental Illness |
Nursing & Custodial Care Facilities |
| Other Name | Type Code |
|---|---|
| THE PETROVA HOUSE | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952800427 | The Community Counseling & Housing Services | Case Management | 10069 Tappan Dr, Saint Louis, MO 63137-2049 | 2018-02-09 |
| 1508365198 | The Community Counseling & Housing Services | Case Management | 460 Shepley Dr, Saint Louis, MO 63137-4026 | 2018-02-08 |
| 1427557081 | The Community Counseling & Housing Services | Psychologist | 4764 Beacon Ave, Saint Louis, MO 63120-2208 | 2018-02-08 |
| 1215436803 | The Community Counseling & Housing Services | Case Management | 4546 Ashland Ave, Saint Louis, MO 63115-2330 | 2018-02-08 |
| 1023517612 | The Community Counseling & Housing Services | Counselor | 2508 N Euclid Ave, Saint Louis, MO 63113-1722 | 2018-02-08 |
| 1922507516 | The Community Counseling & Housing Services | Counselor | 8800 Goodfellow Blvd, Saint Louis, MO 63147-1431 | 2018-02-08 |
| Street Address |
2407 PETROVA AVE |
| City | JENNINGS |
| State | MO |
| Zip Code | 63136-3903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518565993 | Dorothy Smith | Home Health | 2531 Nathan Drive, St Louis, MO 63136 | 2020-10-16 |
| 1538784459 | Rita D Wilson | Technician | 9597 Jacobi Ave Bldg 33 Apt 7, Saint Louis, MO 63136 | 2020-06-16 |
| 1922646728 | Eduhealth Personal Care Services | Technician | 5843 Eagle Valley Dr Saint Louis Mo 63136, Saint Louis, MO 63136 | 2019-12-12 |
| 1558912964 | Homers Haven Home Care LLC | Home Health | 5636 Pamplin Pl, St Louis, MO 63136 | 2019-09-26 |
| 1366096703 | Chloe Suzanne Datillo | Nurse Practitioner | 2865 Netherton Dr., St Louis, MO 63136 | 2019-07-24 |
| 1053976431 | U Auto Be Quik LLC | Non-emergency Medical Transport (VAN) | 10352 Castle Drive, St. Louis, MO 63136 | 2019-05-01 |
| 1164945895 | A Plus Home Health Services LLC | Home Health | 9517 Wilson Bridge Drive, Saint Louis, MO 63136 | 2017-07-25 |
| 1184150302 | Fairview Village Adult Day Care LLC | Clinic/Center | 8449 Jennings Station Rd, Fairview Village Adult Day Care, Saint Louis, MO 63136 | 2017-05-08 |
| 1023541182 | Lots of Love Home Health Services | In Home Supportive Care | 4144 Lindell Blvd. Suite 218, Saint Louis, MO 63136 | 2017-04-06 |
| 1912440876 | Carestl Health | Clinic/Center | 7047 Emma Ave, Jennings, MO 63136 | 2016-11-28 |
| Find all providers in zip 63136 | ||||
| Taxonomy Code | 3104A0625X |
| Grouping | Nursing & Custodial Care Facilities |
| Classification | Assisted Living Facility |
| Specialization | Assisted Living, Mental Illness |
| A facility providing supportive services to individuals who can function independently in most areas of activity, but need special guidance, assistance and/or monitoring as the result of a psychiatric problem. This type of facility requires a staff with special training in mental health training and dealing with psychiatric emergencies. |
| Notes: [7/1/2003: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003434028 | Carolyn Clanton Alf LLC | Assisted Living Facility | 1146 Hamilton Ave, Jennings, FL 32053-2253 | 2020-07-07 |
| 1922404771 | Hidden Oaks Alf, Inc. | Assisted Living Facility | 2089 Nw 69th Ave, Jennings, FL 32053-2337 | 2014-11-06 |
| 1376896555 | Hidden Oaks Alf, Inc | Assisted Living Facility | 7216 Nw 22nd Dr, Jennings, FL 32053-2351 | 2012-10-24 |
| 1902109010 | J & S Adult Livivng Facility | Assisted Living Facility | 1343 Johns St, Jennings, FL 32053-3097 | 2010-12-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497356919 | Cardinal Ritter Institute-resident Services Corp | Assisted Living Facility | 5890 Eichelberger St, Saint Louis, MO 63109-3454 | 2020-11-02 |
| 1831798214 | Smith Care Residential, LLC | Assisted Living Facility | 130 W Culton St, Warrensburg, MO 64093-1720 | 2020-10-18 |
| 1063010890 | Mitchell's Care Center LLC | Assisted Living Facility | 1134 W Norton Rd, Springfield, MO 65803-1070 | 2020-10-14 |
| 1982201935 | J & J Assisted Living LLC | Assisted Living Facility | 104 Wesbecher Ln, Marble Hill, MO 63764 | 2020-10-02 |
| 1144862350 | Humble Abode Residence | Assisted Living Facility | 18 S Duchesne Dr, Florissant, MO 63031-8112 | 2019-10-09 |
| 1700437258 | Midwestern Medical Consultants LLC | Assisted Living Facility | 227 W. Franklin St, Liberty, MO 64068 | 2019-09-26 |
| 1790343804 | Calvin Akins | Assisted Living Facility | 4432 W Belle Pl, Saint Louis, MO 63108-2617 | 2019-06-04 |
| 1245893296 | Michele Vinson Investments LLC Dba Bolivar Manor House | Assisted Living Facility | 404 E Broadway St, Bolivar, MO 65613-2019 | 2019-04-16 |
| 1073079091 | Homes That Care Co. | Assisted Living Facility | 4144 Lindell Blvd Ste 312, Saint Louis, MO 63108-2953 | 2019-02-14 |
| 1609387240 | Tammy Michelle Stone | Assisted Living Facility | 431 Ne County Road 10564, Adrian, MO 64720-5111 | 2017-10-23 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.